[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3074 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 3074

 To ensure and foster continued patient safety and quality of care by 
exempting health care professionals from the Federal antitrust laws in 
   their negotiations with health plans and health insurance issuers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 27, 2005

   Mr. Paul introduced the following bill; which was referred to the 
                       Committee on the Judiciary

_______________________________________________________________________

                                 A BILL


 
 To ensure and foster continued patient safety and quality of care by 
exempting health care professionals from the Federal antitrust laws in 
   their negotiations with health plans and health insurance issuers.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Quality Health Care Coalition Act of 
2005''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to a 2002 survey conducted by the Henry J. 
        Kaiser Family Foundation, 95 percent of the Americans who 
        receive their health care coverage through their employer are 
        enrolled in a managed health care plan, up from 27 percent in 
        1987. Serious questions have been raised about the quality of 
        care patients are receiving under these plans.
            (2) Changes in the health care industry have led to an 
        increased concentration of health care plans, including 
        approximately 177 mergers in the last 13 years. This enhanced 
        concentration has given health care plans significant leverage 
        over health care providers and patients.
            (3) Antitrust laws which prohibit health care professionals 
        from negotiating freely with health care plans infringe on the 
        health care professionals' constitutionally-protected rights of 
        freedom of association and contract.
            (4) Repealing Federal laws which prohibit medical 
        professionals from negotiating collectively with health care 
        plans will create a more equal balance of negotiating power, 
        will promote cooperation, and will enhance the quality of 
        patient care.
            (5) Repealing Federal laws which prohibit medical 
        professionals from negotiating collectively with health care 
        plans will not change the professionals ethical duty to 
        continue to provide medically necessary care to their patients.

SEC. 3. APPLICATION OF THE FEDERAL ANTITRUST LAWS TO HEALTH CARE 
              PROFESSIONALS NEGOTIATING WITH HEALTH PLANS.

    (a) In General.--Any health care professionals who are engaged in 
negotiations with a health plan regarding the terms of any contract 
under which the professionals provide health care items or services for 
which benefits are provided under such plan shall, in connection with 
such negotiations, be exempt from the Federal antitrust laws.
    (b) Limitation.--
            (1) No new right for collective cessation of service.--The 
        exemption provided in subsection (a) shall not confer any new 
        right to participate in any collective cessation of service to 
        patients not already permitted by existing law.
            (2) No change in national labor relations act.--This 
        section applies only to health care professionals excluded from 
        the National Labor Relations Act. Nothing in this section shall 
        be construed as changing or amending any provision of the 
        National Labor Relations Act, or as affecting the status of any 
        group of persons under that Act.
    (c) No Application to Federal Programs.--Nothing in this section 
shall apply to negotiations between health care professionals and 
health plans pertaining to benefits provided under any of the 
following:
            (1) The medicare program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (2) The medicaid program under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.).
            (3) The SCHIP program under title XXI of the Social 
        Security Act (42 U.S.C. 1397aa et seq.).
            (4) Chapter 55 of title 10, United States Code (relating to 
        medical and dental care for members of the uniformed services).
            (5) Chapter 17 of title 38, United States Code (relating to 
        Veterans' medical care).
            (6) Chapter 89 of title 5, United States Code (relating to 
        the Federal employees' health benefits program).
            (7) The Indian Health Care Improvement Act (25 U.S.C. 1601 
        et seq.).
    (d) Definitions.--For purposes of this section:
            (1) Federal antitrust laws.--The term ``Federal antitrust 
        laws'' has the meaning the term ``antitrust laws'' in 
        subsection (a) of the first section of the Clayton Act (15 
        U.S.C. 12(a)), except that such term includes section 5 of the 
        Federal Trade Commission Act (15 U.S.C. 45) to the extent such 
        section 5 applies to unfair methods of competition.
            (2) Health plan and related terms.--
                    (A) In general.--The term ``health plan'' means a 
                group health plan or a health insurance issuer that is 
                offering health insurance coverage.
                    (B) Health insurance coverage; health insurance 
                issuer.--The terms ``health insurance coverage'' and 
                ``health insurance issuer'' have the meanings given 
                such terms under paragraphs (1) and (2), respectively, 
                of section 733(b) of the Employee Retirement Income 
                Security Act of 1974 (29 U.S.C. 1191b(b)).
                    (C) Group health plan.--The term ``group health 
                plan'' has the meaning given that term in section 
                733(a)(1) of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1191b(a)(1)).
            (3) Health care professional.--The term ``health care 
        professional'' means an individual who provides health care 
        items or services, treatment, assistance with activities of 
        daily living, or medications to patients and who, to the extent 
        required by State or Federal law, possesses specialized 
        training that confers expertise in the provision of such items 
        or services, treatment, assistance, or medications.
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